Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 036062589 | IL |
NPI | 1013067669 |
---|---|
Provider Name | Dr. James M Noth |
First Address | Westmont, IL 60559-1394 |
Second Address | Westmont, IL 60559-1394 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 21/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036062589 | (05) | IL |
C40112 | (02) | IL |